Bone filling decreases donor site morbidity after anterior cruciate ligament reconstruction with bone-patellar tendon-bone autografts.

PURPOSE: Bone-patellar tendon-bone (BTB) autograft remains the most widely used graft source for anterior cruciate ligament reconstruction (ACLR). The drawback associated with BTB is increased donor-site morbidity, such as anterior knee pain. The purpose of this study was to evaluate and compare anterior knee pain after refilling the patella bony defect with bone substitute. METHODS: This is a retrospective analysis of consecutive patients who underwent BTB ACLR at a single institution between January 2015 and December 2020. The cohort was divided into two groups; one in which the patellar bony defect was refilled with bone substitute (Bone Graft group) and another in which this the bony defects were not treated (No Bone Graft group). Demographic variables, reported anterior knee pain, visual analog scale (VAS) score, complications, re-operation, and patient reported outcome measures, such as the IKDC, LYSHOLM and SF-12 scores, were compared between groups. RESULTS: A total of 286 patients who underwent BTB ACLR were included. The No Bone Graft group included 88 (30.7%) patients and the Bone Graft group included 198 (69.3%) patients. The Bone Graft group had less anterior knee pain at last clinic follow up (33.3% vs. 51.1% p = 0.004) as well as lower VAS anterior knee pain scores (2.18 vs. 3.13, p = 0.004). The Bone Graft group had lower complications rates (21.7% vs 34.1, p = 0.027). No differences were found in the LYSHOLM, IKDC, and SF-12 scores. CONCLUSION: Bone refilling in BTB ACLR significantly reduces prevalence and severity of anterior knee pain. Larger randomized trials are needed to confirm the benefits of bone refilling in ACLR patients. LEVEL OF EVIDENCE: Retrospective study-III.

Reprint of: Assessment of the use of sediment fences for control of erosion and sediment phosphorus loss after potato harvesting on sloping land.

In humid temperate areas, after harvest of potatoes, it is difficult to prevent soil erosion and diffuse pollution. In some autumn weather conditions, in-field mitigation such as cultivation or sowing are not possible, while edge of field measures can be costly and inflexible. We have assessed the potential of modified sediment fences, widely used on building sites, for erosion mitigation post-harvest of potato crops. Field scale assessments were conducted on fields in the Lunan catchment, eastern Scotland. Sediment retention was estimated by two methods: a topographic survey method using a hand held Real Time Kinematic Global Positioning System (RTK-GPS), and direct measurement of sediment depth using a graduated cane. In the 2010/11 trial the main fence comprised 70 m of entrenched fine mesh (0.25 mm) and coarser mesh (4mm) fabric pinned to a contour fence near the base of the field. This retained an estimated 50.9 m(3) (80.2 tonnes) of sediment, with weighted mean total P (TP) content of 0.09 % in the<2mm soil fraction. In the 2011/12 trial, the main 146 m fence was of intermediate mesh size (1.2mm). The fence was partitioned into nine upslope plots, with 3 replicates of each of 3 cultivation methods: T1 (full grubbing--a light, tined cultivator), T2 (partial grubbing) and T3 (no grubbing). Average plot slopes ranged from 9.9 to 11.0 %. The amounts of TP accumulating as sediment at the fences were: 9.3 (sd=7.8), 11.8 (sd=10.2) and 25.7 (sd=5.8)kg P/ha of upslope plot for the T1, T2 and T3 treatments respectively.

Assessment of the use of sediment fences for control of erosion and sediment phosphorus loss after potato harvesting on sloping land.

In humid temperate areas, after harvest of potatoes, it is difficult to prevent soil erosion and diffuse pollution. In some autumn weather conditions, in-field mitigation such as cultivation or sowing are not possible, while edge of field measures can be costly and inflexible. We have assessed the potential of modified sediment fences, widely used on building sites, for erosion mitigation post-harvest of potato crops. Field scale assessments were conducted on fields in the Lunan catchment, eastern Scotland. Sediment retention was estimated by two methods: a topographic survey method using a hand held Real Time Kinematic Global Positioning System (RTK-GPS), and direct measurement of sediment depth using a graduated cane. In the 2010/11 trial the main fence comprised 70 m of entrenched fine mesh (0.25 mm) and coarser mesh (4mm) fabric pinned to a contour fence near the base of the field. This retained an estimated 50.9 m(3) (80.2 tonnes) of sediment, with weighted mean total P (TP) content of 0.09 % in the<2mm soil fraction. In the 2011/12 trial, the main 146 m fence was of intermediate mesh size (1.2mm). The fence was partitioned into nine upslope plots, with 3 replicates of each of 3 cultivation methods: T1 (full grubbing--a light, tined cultivator), T2 (partial grubbing) and T3 (no grubbing). Average plot slopes ranged from 9.9 to 11.0 %. The amounts of TP accumulating as sediment at the fences were: 9.3 (sd = 7.8), 11.8 (sd = 10.2) and 25.7 (sd = 5.8)kg P/ha of upslope plot for the T1, T2 and T3 treatments respectively.

Sumatriptan use in a large group-model health maintenance organization.

The outcomes of sumatriptan use at a health maintenance organization (HMO) were studied. The study was conducted during one year beginning immediately after sumatriptan was added to the formulary of a large group-model HMO. Subjects were included on the basis of drug-use evaluation criteria, a positive response to the first dose of sumatriptan (administered at the HMO by a nurse), and ability to participate in a telephone survey. Responders to the first dose were eligible to receive up to six doses of sumatriptan for home use. The telephone survey was designed to assess sumatriptan's effects on migraine headache and to capture data on quality of life, perceived problems with sumatriptan, and patient satisfaction. Patients who received sumatriptan between April and September 1993 were interviewed in late September 1993; patients who received sumatriptan between September and April 1994 were interviewed in late April 1994. Of 180 patients surveyed, 160 (89%) had evaluable responses. Migraine headache improved in two thirds of the patients. Sumatriptan was more effective than previously used agents in three fourths. The mean number of migraine headaches per patient per month decreased from 7.4 to 4.2. Quality-of-life indicators, such as time spent with friends, improved in three fourths. Eighty-three percent reported missing fewer days from work. Ninety percent said they would continue to take the drug, despite a 44% incidence of drug-related problems. There were no unexpected problems. A retrospective review showed that utilization of the HMO's resources was reduced with sumatriptan. Placing sumatriptan on an HMO's formulary led to favorable effects on the frequency and severity of migraine headache, patient quality-of-life indicators and productivity, and resource utilization by the organization.